The risk of SPMs in thyroid cancer survivors treated with RAI is slightly increased compared to thyroid cancer survivors not treated with RAI.

Systematic review and meta-analysis, level IV.

Thyroid cancer survivors are at increased risk of SPMs, which may be related to disease-specific treatments or genetic predisposition.

Epidemiologic study, level V.

Given that LIDs reduce urinary iodine measurements, increase I-131 uptake, and possibly improve efficacy of I-131 treatment, we currently favor the use of a 1-2-week LID before I-131 therapy or scanning. However, more research is needed to clarify the role of this dietary intervention.

Background The ACOSOG Z0011 results provided convincing evidence that completion axillary lymph node dissection (CALND) was unnecessary in selected patients with 1–2 positive sentinel lymph nodes (SLNs). We hypothesized that preoperative axillary ultrasound (AUS) with fine needle aspiration is sufficiently sensitive to detect worrisome macrometastasis to preclude need for frozen section pathology of SLNs. Study Design A retrospective single institution study, tertiary academic referral center. 1,140 T1-2 breast cancer patients who underwent SLN biopsy ± CALND, from 1/1/07-12/31/10 were reviewed. All patients had negative preoperative AUS ± FNA. Results 144 (13%) patients were node positive at surgery. Average age, tumor size, histology, ER and PR status were similar comparing 996 SLN negative to 144 (13%) SLN positive patients. Of the SLN positive patients, 25% were premenopausal, 9% were ER negative, and 19% had additional lymph nodes at CALND. Only 19 (2%) patients had SLN metastasis ≥6 mm, 10 (1%) had metastasis >7 mm, and only 1 patient had ≥3 positive SLNs. Conclusions The addition of preoperative AUS ± FNA to patients who meet ACOSOG Z0011 eligibility criteria reduced the risk of macrometastasis measuring ≥6 mm to only 2%, very few of whom would be premenopausal, have ER negative tumors, or ≥3 positive SLNs. With the addition of AUS ± FNA, we endorse the conclusions of the ACOSOG Z0011 trial in avoiding CALND, and see marginal gain in frozen section analysis of SLNs.

Diagnostic/therapeutic study, level IV.

TLPD in patients with ampullary neoplasms results in improved perioperative outcomes while having equivalent short and long-term oncologic outcomes compared to the traditional open approach.